Success Story—‘My life changed for the better when my dad showed me a list of foods with GI values and explained to me why it works.’ – Hannah

What's New?—Dr Neal Barnard’s Program for Reversing Diabetes—The New Glucose Revolution: 3rd US and Canadian edition fully revised and updated

Feedback—Your FAQs Answered

I am vegetarian and two of my favourite foods – mushrooms and tofu – don't appear in the listings. Can you help?

I have been put on a GI diet but am underweight and need to put on at least 5 kilos. I know it is used for reducing weight, but will it help me put on some pounds?

I have PCOS and I know it is genetic. Is there any way I can prevent my baby girl from getting it?

What role should the GI play in an athlete’s choice of foods after high exertion?

Dr Perricone says that one should stay away from high GI foods because they age people. Is this true?

Can you give me a list of acceptable low GI fruits. And should one stay away from watermelon and pineapple?

GI Values Update—Where can I get more information on GI testing?—Where can I get more information on the GI Symbol Program?

A new year, a new look

We have redesigned GI News to make it easier to read, to access past issues, search for information, print articles of interest or recipes that you'd like to prepare, and to link up with sites of interest. But although the look may have changed, just about everything else stays the same. You can still post your comments on our stories and news briefs or send your questions to the GI Group in the usual way.

We wish you all the best for a happy and healthy 2007 and look forward to hearing from you in the months to come.

A new year, new resolutions, a new diet, a new youAs you loosen your belt and renew your vows to cut back on second helpings, dispense with desserts, forego chocolate and hot chips and sign up at the gym, keep in mind that it’s better to be a full-time healthy eater, than a part-time ‘loser.’ Indeed, the biggest loser in the fastest time is possibly destined for the biggest weight regain.

From high protein to low-fat, from eating right for your type to eating like a caveman, any calorie deficit (burning more calories than you eat) diet can help you lose weight. But the real name of the game is maintaining that weight loss for your long-term health and wellbeing including reducing your risk of heart disease and diabetes. It’s not a competition to be the biggest loser in the shortest time. It’s the challenge of converting your old eating and lifestyle patterns into new and healthy ones you can happily live with for a lifetime.

Don’t be tempted to measure success by the number of dress sizes dropped or belt notches tightened in just 3 months. It’s a real achievement to lose 5% of your initial weight in whatever time it takes. And the real success is preventing weight regain by sticking to your healthier lifestyle.

If you do want to lose a bit more weight, take the pressure off for 3 months before you restrict calories again. This will give your body time to adjust to its new engine size. And it will give you practice in learning to listen to your body’s natural signals for feeling hungry and feeling full just as babies and toddlers do. An alternating weight loss/weight maintenance pattern like this will help you become a successful full-time weight maintainer.

Of course, in theory preventing weight regain should be a lot easier than losing weight. But if anything, it is the most critical stage of all. Here’s why regaining weight after you have been on a diet is all too easy. For starters your body fights back. Food-seeking behaviour is wired into our brains to make sure we survive when our energy intake is low. So, despite your good intentions, those hormones fly into action to stimulate your appetite and encourage excessive food intake. But your body is a smaller engine at your new weight and it needs less fuel to run. And if you lost weight rapidly and without exercising, then chances are you also lost excessive amounts of muscle, making your engine size even smaller.

Another reason why it can be so hard to maintain weight loss is that your resting metabolic rate (RMR) has dropped so your energy expenditure declines by as much as 10%. This is how nature helps animals adapt to the environment in which they live. If food is scarce, the body reduces engine revs so it can get by with less fuel.

To lose weight and keep it off, the bottom line is that you need to remain focused on eating well and exercising regularly. The 10 golden rules of preventing weight regain are:

Never skip meals (or you will slow your metabolic rate).

Eat a good breakfast.

Eat at least three times a day (but listen to your appetite and eat accordingly.

Limit television to less than 12 hours per week.

Choose low GI carbs at every meal.

Eat lean protein sources at every meal.

Don’t skimp on the fats – just choose healthy ones.

Eat two serves of fruit and five serves of vegetables every day.

Schedule (put it in your diary if you have to) moderate physical activity for 30–60 minutes on six days out of seven.

Go nuts for almonds and reduce your blood glucoseEating a fistful (2 oz/60 g) of almonds (the natural ones not the salted roasted, or sugar coated ones), significantly reduced those white bread blood glucose spikes according to a new study published in The Journal of Nutrition. Co-author Dr Cyril Kendall from the University of Toronto says: ‘Almonds have already been found to reduce LDL cholesterol levels and contain a variety of important nutrients. This new research shows that incorporating almonds in the diet may help in the management of blood glucose levels and the onset of such illnesses as diabetes, while promoting a healthy heart.’

The small study looked at the effects of five meals eaten on five different occasions by 15 healthy young men and women. They ate the control meal (white bread) twice and then the three test meals – 60 g raw unblanched almonds with white bread, Uncle Ben’s parboiled converted rice and instant mashed potatoes. The latter two were balanced for fat, protein and total energy with the almond meal with butter and cheese. After each meal, the volunteers had their blood drawn to check glucose, insulin and oxidative stress levels.

The GI values of the almond and white bread (55) and parboiled rice (38) meals were significantly less than the mashed potato meal (94) and this difference was clearly reflected in the significantly smaller rises in the volunteers’ blood glucose levels after eating the almond and rice meals. What this shows is that eating almonds ‘can have a significant impact in blunting the glycemic and insulin responses of the body when fed with a carbohydrate (bread in this case) meal,’ said Kendall

And there’s more. The researchers found less oxidative damage after the volunteers ate the almond meal and suggest that including antioxidant-rich almonds in a low GI diet may reduce the risk of heart disease and diabetes through mechanisms beyond their impact on blood sugar levels.– The Journal of Nutrition, December 1 2006

GI Group: So, what’s so special about almonds?These tasty tidbits pack a nutritional punch. They are rich in protein, calcium, vitamin E and arginine (an amino acid that helps to keep your blood flowing smoothly). They also contain good amounts of fibre, iron and zinc. They contain relatively little carbohydrate, so don’t have a GI value. Although they are high in fat, it’s largely the heart healthy poly and monounsaturated types. Studies have shown that almond skins contain some 30 different antioxidant compounds. So buy the whole natural ones with the skin on and enjoy a handful for a snack or add them in your cooking. Here are 10 tips on how to get more from dietitian Nicole Senior from her forthcoming book (with home economist Veronica Cuskelly), Eat to Beat Cholesterol (to be published in March 2007):

Add slivered or chopped almonds to muesli.

Top fruit and yoghurt, fruit puddings and parfaits with slivered or chopped almonds.

Bake apples or pears with a filling of chopped almonds and mixed dried fruit.

Even more reasons to eat those low GI oatsBeta-glucan is a polysaccharide (sugar) derived from foods like oats and barley that’s recognised for its ability to lower blood cholesterol levels. New research published in the European Journal of Clinical Nutrition reveals even more beta-glucan benefits, for carbohydrate metabolism and blood pressure. Ninety-seven men and women (average age 60, average BMI 32.4) were randomly assigned to eat oat beta-glucan or control foods (with maltodextrin) for 12 weeks in a double-blind, controlled trial.

Photo: Ian Hofstetter

The researchers found that peak insulin levels after meals decreased for the beta-glucan group but not the control group. Similarly, blood pressure was also lowered in obese participants.– European Journal of Clinical Nutrition advance online publication 6 December 2006; doi: 10.1038/sj.ejcn.1602562

Does sugar cause diabetes? No. There is absolute consensus that sugar in food does not cause diabetes, and there has been for some time. And if we are to deal with the increasing rates of diabetes worldwide, it’s essential to deal with the real risk factors. Type 1 diabetes is an autoimmune condition triggered by unknown environmental factors, such as viruses. Type 2 diabetes is strongly inherited, but lifestyle factors such as lack of exercise, central obesity and being overweight, increase the risk of developing it. In the past, when the diabetes diets prohibited sugar, many people (including health professionals) joined the dots and drew the conclusion that simple sugars were the villain of the piece and responsible for high blood glucose levels. We now know that’s not true – research at Harvard University has shown that it’s high GI diets (not high sugar intake) that increase blood glucose levels and the risk of developing both type 2 diabetes and heart disease. But it’s hard to change minds, let alone ‘popular opinion’. A recent study may help.

In the December issue of Diabetes, Steven Hunter and colleagues from the Royal Victoria Hospital, Belfast, report that a high sucrose intake as part of a weight maintaining diet had no detrimental effect on insulin sensitivity or glycemic profiles in healthy people without diabetes. In the small randomised, cross-over trial, 13 healthy young men ate either a high sugar (200 grams per day) or ‘average’ sugar (80 grams per day) diet for six weeks. They then had a ‘wash out’ period for 4 weeks before crossing over to the other diet. The results showed no significant differences in insulin resistance, or weight gain on either group, nor differences in glucose uptake or glucose production. Finally, there were no adverse changes in the elasticity of the arteries or the men's glycemic profiles on either diet.– Diabetes, Dec 1, 2006; 55 (12)

GI Group: Notwithstanding this finding, empty calories whatever the source, sugar, starch, fat, or alcohol won’t keep your body operating optimally. ‘Moderation in all things’ is one of those sayings that has withstood the test of time for obvious reasons. You can enjoy refined sugar in moderation – that’s about 40–50 grams a day – an amount that most people consume without thinking about it, and somewhat less than the ‘average’ 80 grams in the trial described above. Try to include sweetened foods that provide more than just kilojoules – dairy foods, breakfast cereals, porridge with brown sugar, jam on whole grain toast etc. Most diabetes organisations all around the world no longer advise strict avoidance of refined sugar or sugary foods. This is one of the happy spin-offs from research on the GI – recognition that both sugary foods and starchy foods raise your blood glucose. Furthermore, scores of studies indicate that moderate amounts of sugar in diabetic diets (for example 30–50 grams or 6–10 teaspoons) does not result in either poor control or weight gain. So cut the guilt trip and allow yourself the pleasure of sweetness.

SoybeansDid you know that legumes are the only food group associated with longevity? Accredited Practising Dietitian Sue Radd says that ‘what is truly remarkable is that all the longest living societies are into some sort of bean, whereas the chronically ill in Western countries often don't even know what a legume looks like!’ Soybeans (GI 14 canned; GI 18 home cooked) and soy products are the nutritional powerhouse of the legume family. They come in various colours, shapes and sizes; are used to make miso, tofu, soy drinks and tempeh; have been a staple part of Asian diets for thousands of years; and are an excellent source of protein. They’re also rich in fibre, iron, zinc and vitamin B. Soybeans are lower in carbohydrate and higher in fat than other legumes, but the majority of the fat is polyunsaturated. They are a rich source of phytochemicals, especially phytoestrogens, and have been linked with improvements in blood cholesterol levels, relief from menopausal symptoms and lower rates of cancer in many studies. Soak dry soybeans overnight in plenty of water and use them to make soups, stews and casseroles, or mash them when cooked and use in burgers or as a base for dips.

Green soybeans also called edamame (not GI tested as yet) are fresh, bright green soybeans in their pod. You can buy them fresh or frozen from Asian produce stores. You can serve them at home as a side dish or toss into a pasta, risotto or stir fry. Sue Radd, an authority on phytoestrogens, has many wonderful soybean (and soy product) recipes in her book Eat to Live, which she co-authored with Prof. Kenneth Setchell from the Cincinnati Children’s Hospital Medical Centre and the University of Cincinnati. To order, check out Sue’s website: www.sueradd.com. Here are her irresistible Roasted Soy Nuts – the perfect snack (a small handful will stay the pangs) or addition to salads.

Preheat the oven to 180ºC (350ºF). Drain soybeans and spread out on two non-stick oven trays. Roast in the oven for about 45 minutes, stirring occasionally, until the soybeans are golden brown. Remove from the oven and place in a mixing bowl.

Heat the oil and drizzle over the soybeans. Mix well so that each soybean is coated. Sprinkle the soybeans with the ground spices, mixing well. Adjust to taste with salt and chilli. Serve immediately or store in an airtight container for later use.

Vietnamese pork stir-fryThis gluten-free recipe comes from dietitian Sue Shepherd’s new book, Two Irresistible for the Irritable. The recipes aren’t specifically designed to be low GI, but many will be, so there’s plenty to tempt anyone on a gluten-free diet with in this book where every recipe is photographed. Sue is an Accredited Practising Dietitian who also has coeliac disease. She has taken a leading role in Australia in the dietary management of coeliac disease and irritable bowel syndrome and is in demand as a speaker internationally. She is completing her PhD in the dietary management of coeliac disease, irritable bowel syndrome and fructose malabsorption. Check out Sue’s website for more information or to order her books: www.coeliac.com.au

Place pork strips, fish sauce, lime juice, brown sugar, ginger, chillies and garlic in a bowl. Toss well to combine and set aside, covered, in the refrigerator to marinate for 3 hours.

Heat 1 tablespoon of oil in a large wok or frypan over high heat. Add half the pork strips and stir fry for 2 minutes until browned and just cooked through. Remove the pork from the pan, set aside on a plate. Repeat cooking the remaining pork in 1 tablespoon of oil.

Heat the remaining tablespoon oil in the wok, add the capsicum, snow peas and celery and stir fry over high heat for 2 minutes.

In a small bowl, mix the cornflour together with a little vegetable stock to form a paste. Gradually add the remaining vegetable stock until well blended. Pour over the vegetables, heating on high until thickened.

Add the pork strips, coriander and mint, stir for 30 seconds until heated through and serve with steamed rice or rice noodles.

GI Solo: Gold & green fruit saladThis fresh fruit salad with its gingery tang is literally made in minutes. It is a great way to start the day with zing, or end a meal with a clean, fruity finish. The GI is likely to just fall over the line from low to moderate even though both the ginger and kiwi fruit have low GI values. If you are a ginger lover, check out September 2006 GI News, as we reported on the GI values of a number of Buderim Ginger products. To order online or find your nearest stockist (they export to 17 countries) here’s the link: www.buderimginger.com

GI Solo: Middle East roll upA great way to add to your vegetable intake – and delicious as is or very lightly toasted in a sandwich press. When made the traditional Mexican way, tortillas have low GI values and a corn tortilla is a good alternative to bread if you are gluten intolerant. Even using pita bread or a flat or mountain bread wrap, this recipe is likely to have a low GI because of the hummus (GI 6). Recipe reproduced from The Pea & Lentil Cookbook with permission from the USA Dry Pea and Lentil Council.

Serves 1

Spread ¼ cup hummus to within 2.5 cm (1 inch) of the edge of a 30 cm (10 inch) tortilla. Scatter over the hummus, off centre of the tortilla, ½ cup finely chopped broccoli, 1/3 cup shredded red cabbage, and 1/3 cup sliced mushrooms. Fold the edge of the tortilla over the vegetables, then turn in envelope style and roll up.

‘My life changed for the better when my dad showed me a list of foods with GI values and explained to me why it worked’– Hannah‘After years of being lethargic and having my weight yo-yo and trying numerous ways to cope with those issues I discovered the wonderful glycemic index, which has been my saviour. Prior to my learning about the GI, I watched and followed my parents try all sorts of diets. We cut out carbs, increased protein, followed points, fasted and ate things at certain times of the day. Nothing seemed to work to get our weights down and to increase our energy. I went to the doctor at age 20, am now 26, believing that I was diabetic and was diagnosed with hypoglycemia. I wasn’t really told what to eat by the doctor except that I should eat between meals. For many years I snacked but remained overweight and lethargic especially after meals. I would call this my carbo-coma. Due to this, my work performance suffered as did my home life as all I wanted to do was sleep. At work I would literally fall asleep with my hands on the keyboard and would have to pump myself with coffee to stay awake.

My life changed for the better when my dad showed me a list of foods with GI values and explained to me why it worked. I thought I might as well give it a try, since I had tried everything else. I love a wide variety of foods and didn’t feel like this way of eating would prevent me from eating what I loved most – good food. When I started eating low GI foods I wasn’t exercising much but within a few weeks I was noticing that I was losing weight, not to mention that I wasn’t falling in to my ‘carbo-coma’ in the afternoon after lunch. I didn’t need to snack as often either. I was hooked.’

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So, what does it mean to reverse diabetes? ‘Rethinking the foods you eat’ says Dr Neal Barnard (physician, clinical researcher, and adjunct associate professor of medicine at the George Washington University School of Medicine). ‘Most people with type 2 diabetes find themselves on a road leading toward gradually increasing weight, slowly rising blood glucose, higher doses of medications and worsening complications.’ It doesn’t have to be that way he says. His research findings, which have been published in peer-reviewed journals (see GI News September 2006), show that people with diabetes can reverse this trend. His vegan program is an aggressive nutritional one, but absolutely achievable as the results clearly show. There are three key guidelines:

Set animal products aside.

Keep vegetable oils to a minimum.

Favour foods with a low GI.

According to Barnard, you’ll find that the side effects are good ones: weight loss, lower cholesterol levels, lower blood pressure, and increased energy. The book sets out his research findings, explains the program he has devised and includes menus and recipes by Bryanna Clark Grogan.For more information on cholesterol, nutrition, meal planning and recipes visit: www.pcrm.org

To be published in the UK in February as The Reverse Diabetes Diet by Rodale International.

This book by the world’s foremost authorities on the glycemic index remains the definitive introduction to and an essential source of new information for anyone wanting to understand the science behind the GI, the health benefits of low GI carbs and how to ‘make the switch’ to low GI eating. This fully revised 3rd US and Canadian edition includes findings from the latest research on GI and weight loss, diabetes, cardiovascular disease and the metabolic syndrome. There are also new chapters on managing PCOS with low GI eating and on vegetarian low GI eating, tables of GI values for more than 500 popular foods, recipes, and answers to nearly 50 of the most frequently asked questions about the GI.

I am vegetarian and two of my favourite foods – mushrooms and tofu – don't appear in the listings. Can you help?Mushrooms have so little carbohydrate, the GI can’t be measured. And despite being derived from soybeans, tofu in fact is a protein-rich food with negligible carbs so again the GI isn’t relevant. Eat them to your heart’s content. You may also like to update your bookshelf with a copy of The Low GI Vegetarian Cookbook (by Jennie Brand-Miller, Kaye Foster-Powell and Kate Marsh with Philippa Sandall) et al. It features numerous recipes with tofu and mushrooms (like the one shown below) and shows you how to combine the basics of a healthy vegetarian or vegan diet with the benefits of low GI carbs. You’ll find it in all major bookstores or from Amazon. And to keep up with the latest GI values on a regular basis (for free), check out the University of Sydney GI database at www.glycemicindex.com.

photo: Ian HofstetterI have been put on a GI diet but am underweight and need to put on at least 5 kg. I know it is used for reducing weight, but will it help me put on some pounds?Dietitian Kaye Foster-Powell says: ‘A low GI diet is healthy for you whatever your weight and a higher calorie version could be developed for you to facilitate weight gain. My only reservation is that you may find it difficult to consume the larger quantity of food that would be necessary to increase the calorie value of the diet. It depends on the reason why you are underweight. Have you been sick, do you exercise a lot, lost your appetite or is it simply in your genes? If being underweight is the problem, you have to look at the cause and then explore options to find the best way to address it.’

I have PCOS and know it is genetic. Is there any way I can prevent my baby girl from getting it?‘This question is a difficult one to answer,’ says dietitian Kate Marsh, author of The Low GI Guide to Managing PCOS and Living Well with PCOS, ‘as there are no specific guidelines for preventing PCOS. We do know that it is genetic and therefore the best thing to do is to eat a healthy diet and be active as a family and hopefully she will adopt these good habits as she grows!

Kate Marsh

Current research suggests that diets low in saturated fat and high in fibre are associated with a lower risk of diabetes as are diets with more wholegrains and a lower GI. Since the underlying problem in both type 2 diabetes and PCOS (in most cases) is insulin resistance, these findings are also relevant to women with PCOS. We also know that exercising regularly protects against diabetes and improves insulin sensitivity. And of course, a combination of healthy eating and regular physical activity helps with weight management, which also helps with insulin sensitivity. Ensuring your daughter has a healthy rate of weight gain as she grows (not too much or too little) may also help in reducing her risks of health problems including PCOS.

So, the best advice we can give right now is for you to encourage your daughter as she grows to eat a good variety of fruits, vegetables and wholegrains, lean protein foods and dairy products (low fat varieties are not recommended for children under 2 years of age) or alternatives. Highly processed carbohydrate foods and those high in saturated fat and sugar with a poor nutritional value (e.g. sweet biscuits, pastries, chips, lollies and soft drinks) are best kept for occasional treats rather than everyday choices. If you need some more specific advice, make an appointment to talk with a Registered Dietitian (RD) who has experience in PCOS to help you developing a healthy eating plan for her.’

What role should the GI play in an athlete's choice of foods to replenish glycogen storage in their muscles after high exertion?Dr Emma Stevenson, lecturer in sport and exercise nutrition at Northumbria University in Newcastle Upon Tyne says: ‘Recovery after exercise poses an important challenge to athletes.

The depletion of muscle glycogen stores through periods of high exertion or prolonged endurance exercise provides a strong drive for its own resynthesis. However, carb intake is vital to maximise glycogen resynthesis during the post-exercise period. Muscle glycogen resynthesis is facilitated by both insulin and a rapid supply of glucose. This is why we recommend that athletes consume high GI carbs in the early recovery phase to enhance re-fuelling – approximately 50–100 grams of high GI carbs as a sports drink or snack within the first 30 minutes after exercise. If the recovery time between exercise sessions is longer than 4 hours, the GI of the carbs is less important. Research has shown that endurance capacity during prolonged running was improved and performance in high intensity intermittent running was not effected 24 hours after a low GI recovery diet was consumed compared to when a high GI diet was consumed. So what’s the take-home message? If recovery time is short, consume high GI carbs immediately after exercise to facilitate muscle glycogen resynthesis. If recovery time is longer, the GI of carbs may be less important as long as you consume sufficient carbohydrate.’

Dr Perricone says that one should stay away from high GI foods because they age people. Is this true?Scientists are beginning to find connections between high blood glucose levels and diseases such as dementia. As we age, abnormal protein deposits form in parts of the brain and eventually interfere with normal mental functioning. High glucose levels accelerate this process. Indeed, the abnormal proteins are called advanced glycosylated endproducts (AGE for short).

To get a feel for how this happens, think about the browning reactions that occur naturally during cooking – think of toasting, baking and grilling. When sugar is present, the reactions occur faster, sometimes leading to excess browning, i.e. burning. The same reactions between sugars and proteins occur very slowly inside the body. Gradually the proteins become burdened by the presence of the freeloading sugar molecules and lose the ability to do their job. When that happens to a long-lived protein like the collagen in skin, the elasticity and natural glow of youthful skin fades. The result: wrinkles. We can’t stop it entirely but we can slow it down.– Source: Low GI Eating Made Easy available in ANZ (published by Hachette Livre), the UK (Hodder Mobius), and the US and Canada (Marlowe & Company).

Can you give me a list of acceptable low GI fruits. And should one stay away from watermelon and pineapple?Fruit (and vegetables) play a key role in a low GI diet. The greater the variety the better. People who eat three or four serves of fruit a day, particularly apples and oranges, have the lowest overall GI and the best blood glucose control. As a general rule, the more acidic a fruit is, the lower its GI. Temperate climate fruits – apples, pears, citrus (oranges, grapefruit) and stone fruits (peaches, plums, apricots) – all have low GI values.

Tropical fruits – pineapple, paw paw, papaya, banana, rockmelon and watermelon tend to have higher GI values, but their glycemic load (GL) is low because they are low in carbohydrate. So keep them in the fruit bowl and enjoy them every day if you wish as they are excellent sources of anti-oxidants. Check out ‘The Top 100 Low GI Foods’ in Low GI Eating Made Easy for the lowdown on fruit and ideas for including more in your diet.

Where can I get more information on the GI symbol program?The GI symbol on a food is a guarantee that the stated GI value is reliable and that the food is a healthy choice in its food group. To earn certification, foods that carry the symbol must be a good source of carbohydrate and meet a host of other nutrient criteria including kilojoules (calories), total and saturated fat, sodium (salt), and where appropriate, dietary fibre and calcium. The GI Symbol Program is a public health initiative run by Glycemic Index Limited, a non-profit company whose members are the University of Sydney, Diabetes Australia and the Juvenile Diabetes Research Foundation.

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